Building community ownership of maternal and child health interventions in rural Nigeria: A community-based participatory approach

Although community engagement has been widely reported in the literature, there have been limited reports of this approach in many African countries. We report the methods of community engagement used in an implementation research that was designed to increase women's use of primary health centres for skilled pregnancy and child health care in rural Nigeria. The study was conducted in 20 communities in two Local Government Areas of Edo State in Nigeria. The study used a community-based participatory approach in engaging the project communities through all phases of the project cycle. Some of the activities for achieving community ownership of the project included advocacy activities and engagement with community stakeholders; community conversations; the identification and training of ward development committees; and community sensitization workshops. The project was implemented over three years - November 2017 to October 2020. Key informant interviews conducted at the end of the project reported narratives on key points that were appreciated by community members. These included the recognition given to the community members in decision-making, the elimination of costs through the health insurance scheme, the transparency and accountability embedded in the project implementation, and the absence of adverse maternal and child health outcomes during the project implementation. We conclude that the use of a community-based participatory approach enhanced the attainment of positive outcomes for a project designed to improve the use of skilled pregnancy care in rural Nigeria.